The Science of Rheumatoid Arthritis Flashcards
What is rheumatology?
Rheumatology = medial speciality that deals with patients with arthritis and other related conditions
What is arthritis?
Arthritis = inflammation of a joint
What is the clinical presentation of arthritis?
- Symptoms
- Pain
- Stiffness
- Swelling
- Functional impairment
- Systemic symptoms
- Signs
- Tenderness
- Swelling
- Restriction of movement
- Heat
- Red
- Systemic features
What are examples of rheumatic diseases?
- RA
- Sero nergative arthritis
- Crystal arthritis
- Connective tissue diseases
- Systemic vasculitis
- Bone disease
- Osteoarthritis (most prevalent kind of arthritis)
What does RA stand for?
Rheumatoid arthritis
What is the most prevalent kind of arthritis?
Osteoarthritis
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) = chronic, autoimmune systemic illness characterised by a symmetrical peripheral arthritis and other systemic features
What can RA be associated with?
- Joint damage
- Disability
- Premature mortality
Describe how RA is classified?
Score of 6 or above is needed for classification of patient to deffinitely have RA:
- joint involvement
- serology
- acute-phase reactants
- duraction of symptoms
What is the prevalence of RA?
1% of population
What sex and age group does RA mostly affect?
- Females > males 3:1
- Age groups 4th and 5th decade
What is the aetiology of RA?
- Genetic
- Genetic contribution estimated to be about 50%
- Closes association with specific amino acid sequences at positions 70-74 of DRB1
- Environment
- Smoking
- Chronic infection
- Such as periodontal disease
Describe the pathology of RA?
- Synovitis
- Inflamed synovium
- Inflamed joint capsule
- Damages surrounding structures
- Cartilage
What investigations are done for RA?
- Immunology
- Rheumatoid factor (IgG, IgM)
- Not used anymore
- Anti-cyclic citrullinated antibodies (anti CCP, ACPA)
- Rheumatoid factor (IgG, IgM)
- Imaging
- X-ray
- USS
What antibodies are checked to diagnose RA?
- Anti-cyclic citrullinated antibodies (anti CCP, ACPA)
What are the clinical features of RA?
- Symptoms
- Pain
- Stiffness
- Immobility
- Poor function
- Systemic symptoms
- Nonspecific – fatigue, weight loss, anaemia
- Specific – eyes, lungs, nerves, skin, kidneys
- Long term – CVS, malignancy
- Signs
- Swelling
- Tenderness
- Limitation of movement
- Redness
- Heat
How many joints are usually inflammed in RA?
With RA usually more than 1 joint is inflamed, normally bilateral (symmetrical polyarthritis)
How is the severity of RA assessed?
- Disease severity score (DAS)
-
www.das28.com
- DAS <2.4 represents clinical remission
- SAD >5.1 represents eligibility for biological therapy
-
www.das28.com
What does DAS stand for?
Disease severity score
What is the main concern in terms of the prognosis of RA?
- Massive impact on work
- About 33% stopped working within 2 years, 50% within 10 years
- 40 sick days per year instead of average 6.5
